Intervention Review

Antibiotic prophylaxis for mammalian bites

  1. Iara Marques Medeiros1,*,
  2. Humberto Saconato2

Editorial Group: Cochrane Wounds Group

Published Online: 23 APR 2001

Assessed as up-to-date: 10 FEB 2001

DOI: 10.1002/14651858.CD001738


How to Cite

Medeiros IM, Saconato H. Antibiotic prophylaxis for mammalian bites. Cochrane Database of Systematic Reviews 2001, Issue 2. Art. No.: CD001738. DOI: 10.1002/14651858.CD001738.

Author Information

  1. 1

    Federal University of Rio Grande do norte, Infectious Diseases Department, Natal, Rio Grande do Norte, Brazil

  2. 2

    Federal University of Rio Grande do norte, Department of Medicine, Sao Paulo, Vila Clementino, Brazil

*Iara Marques Medeiros, Infectious Diseases Department, Federal University of Rio Grande do norte, Rua Moraes Navarro, 2082 Ed. Vermont - Apartment 800, Natal, Rio Grande do Norte, 59075-770, Brazil. imm@ufrnet.br.

Publication History

  1. Publication Status: Edited (no change to conclusions)
  2. Published Online: 23 APR 2001

SEARCH

 

Abstract

  1. Top of page
  2. Abstract
  3. Plain language summary
  4. 摘要

Background

Bites by mammals are a common problem and they account for up to 1% of all visits to hospital emergency rooms. Dog and cat bites are the most common and people are usually bitten by their own pets or by an animal known to them. School-age children make up almost a half of those bitten. Prevention of tetanus, rabies and wound infection are the priorities for staff in emergency rooms. The use of antibiotics may be useful to reduce the risk of developing a wound infection.

Objectives

To determine if the use of prophylactic antibiotics in mammalian bites is effective in preventing bite wound infection.

Search methods

Relevant RCTs were identified by electronic searches of MEDLINE, EMBASE, LILACS and the Cochrane Controlled Trials Register databases in November 2000.

Selection criteria

We included randomised controlled trials which studied patients with bites from all mammals. Comparisons were made between antibiotics and placebo or no intervention. The outcome of interest was the number of infections at the site of bite.

Data collection and analysis

Two reviewers extracted the data independently. All analyses were performed according to the intention-to-treat method.

Main results

Eight studies were included. The use of prophylactic antibiotics was associated with a statistically significant reduction in the rate of infection after bites by humans. Prophylactic antibiotics did not appear to reduce the rate of infection after bites by cats or dogs. Wound type, e.g. laceration or puncture, did not appear to influence the effectiveness of the prophylactic antibiotic. Prophylactic antibiotics were associated with a statistically significant reduction in the rate of infection in hand bites (OR 0.10, 95% CI 0.01 to 0.86; NNT = 4, 95% CI 2 to 50).

Authors' conclusions

There is evidence from one trial that prophylactic antibiotics reduces the risk of infection after human bites but confirmatory research is required. There is no evidence that the use of prophylactic antibiotics is effective for cat or dog bites. There is evidence that the use of antibiotic prophylactic after bites of the hand reduces infection but confirmatory research is required.

 

Plain language summary

  1. Top of page
  2. Abstract
  3. Plain language summary
  4. 摘要

Antibiotics for reducing the rate of infection after bites by mammals such as humans

Bite wounds may become infected due to the transfer of bacteria from the mouth of mammals into the skin. There was a decrease in the risk of developing an infection after a human bite when given antibiotics. Antibiotics also decreased the chance of developing a wound infection after a bite on the hand. Further studies are required to confirm these findings.

 

摘要

  1. Top of page
  2. Abstract
  3. Plain language summary
  4. 摘要

背景

預防性抗生素用於被哺乳動物咬傷之患者

被哺乳動物咬傷是一頗為常見的問題,在醫院急診室的就醫中就佔了將近1% 。被狗跟貓咬到是最常見的,且大多是自己的寵物或認識他們的動物所為,其中學齡兒童幾乎佔了被咬傷人口的半數。預防破傷風、狂犬病和傷口感染是急診室人員處置被咬傷患者時的重點,而使用抗生素則可以有效減少傷口發生感染。

目標

探討預防性抗生素是否能夠有效預防被哺乳動物咬傷的傷口發生感染。

搜尋策略

我們在2000年11月透過電子化搜尋 MEDLINE, EMBASE, LILACS and the Cochrane Controlled Trials Register databases等資料庫,尋找出相關的隨機對照試驗 (RCTs) 。

選擇標準

我們納入了研究主題為 ‘被哺乳動物咬傷之患者’ 的隨機對照試驗,這些試驗比較了抗生素和安慰劑或無介入之間的差異,結果指標則是被咬傷部位發生感染的人數。

資料收集與分析

由兩位作者獨立摘錄資訊,且所有分析都按照治療意向分析法(intentiontotreat method)來進行。

主要結論

我們共納入了8個研究,使用預防性抗生素可顯著降低被人類咬傷後發生傷口感染的比率,不過對於貓或狗咬傷的傷口,則並未顯示抗生素可降低其發生感染的比率。傷口的型式,比方說撕裂傷或是穿刺傷,看起來並未影響預防性抗生素的效果。預防性抗生素可顯著降低手部咬傷傷口發生感染的比率 (OR 0.10, 95% CI 0.01 to 0.86; NNT = 4, 95% CI 2 to 50) 。

作者結論

根據1項研究的數據顯示預防性抗生素可以減少人類咬傷傷口的感染,不過還需要更多研究才能證實。沒有證據顯示預防性抗生素對貓狗咬傷的傷口是有效的。有實證顯示預防性抗生素可有效降低手部傷口的感染,然而仍進行更多研究後方可證實。

翻譯人

本摘要由成功大學附設醫院邱曉萱翻譯。

此翻譯計畫由臺灣國家衛生研究院 (National Health Research Institutes, Taiwan) 統籌。

總結

抗生素也許能夠降低被人類咬傷、或咬傷部位在手部時發生傷口感染的比率。細菌可能透過哺乳類動物的口腔進入人類皮膚而造成傷口感染。被人類咬傷之後給予抗生素將可減少傷口發生感染的風險,抗生素還可以降低咬傷部位在手部時的傷口感染,然而還需要更多研究來進一步證實這些發現。